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COMP EXAM 2022 > 560I FUNC MED NUTRITION > Flashcards

560I FUNC MED NUTRITION Flashcards

1
Q 
When very low erythrocyte magnesium is found, the patient is likely to have what other type of insufficiency?
A.) Selenium
B.) Iron
C.) Glutathione
D.) Vitamin
A

C

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2
Q

Which of the following is a good test for copper excess?
A.) RBC Cu
B.) Urinary copper
C.) Low serum copper to ceruloplasmin ratio
D.) Urinary HVA/VMA ratio

A

B.) Urinary copper

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3
Q 
What element has been shown to protect from the toxic effects of mercury?
A.) Copper
B.) Selenium
C.) Zinc
D.) Magnesium
A

B.) Selenium

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4
Q

What effect does delayed specimen transport have on relative levels of glutamate and glutamine?
A.) The levels are stable for at least one week.
B.) Glutamine is consumed by enzymes in plasma
C.) Glutamate decreases due to changes in pH
D.) Glutamine is slowly hydrolyzed to glutamate

A

D.) Glutamine is slowly hydrolyzed to glutamate

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5
Q 
Which amino acid, when administered as a challenge for testing status of a vitamin, helps to alleviate one of the effects of deficiency of the vitamin?
A.) Tryptophan
B.) Phenylalanine
C.) Histidine
D.) Isoleucine
A

C.) Histidine

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6
Q

The principal advantage of free form amino acid supplements over purified protein products is
A.) Lower risk of producing nitrogen overload
B.) Greater penetration into distal regions of the gut lumen C.) More rapid delivery of amino acids into peripheral blood D.) Lower risk of gall bladder attacks due to release of cholegogues

A

C.) More rapid delivery of amino acids into peripheral blood

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7
Q

Which abnormality pattern, when found on a plasma fatty acid report, indicates that a patient is in general essential fatty acid deficiency?
A.) Elevated stearic/oleic ratio
B.) Low ALA, EPA, DHA and high stearic acid
C.) Low Mead and palmitic acids
D.) Low omega 3 and omega 6 with elevated Mead acid

A

D.) Low omega 3 and omega 6 with elevated Mead acid

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8
Q 
Which abnormality pattern, when found on a plasma fatty acid report, indicates that a patient is in omega-3 fatty acid deficiency?
A.) Low stearic/oleic ratio
B.) Low ALA and EPA
C.) Low LA, DGLA and AA
D.) High palmitic/palmitoleic ratio
A

B.) Low ALA and EPA

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9
Q

Which abnormality pattern, when found on a plasma fatty acid report, suggests that a patient may be hypertriglyceridemic?
A.) An elevated triene/tetraene ratio
B.) Low levels for all omega-3 and omega-6 fatty acids
C.) All saturated and monounsaturated fatty acids found in their 4th or 5th quintiles
D.) A low triene/tetraene ratio

A

C.) All saturated and monounsaturated fatty acids found in their 4th or 5th quintiles

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10
Q 
Finding multiple odd-chain fatty acids in erythrocytes means that there is some process causing elevated levels of which compound?
A.) Stearate
B.) Fumarate
C.) Erucate
D.) Propionate
A

D.) Propionate

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11
Q 
Which fatty acid source is appropriate for treatment of a patient with ALA and EPA in their upper quintiles and with LA and GLA in their first deciles?
A.) Flax oil
B.) Primrose oil
C.) Fish oil
D.) Corn oil
A

B.) Primrose oil

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12
Q 
What is the common name for the fatty acid written as 20:4n6?
A.) Arachidonic acid
B.) GLA
C.) EPA
D.) Linoleic acid
A

A

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13
Q 
Which of the following is a urinary organic acid that becomes elevated as a direct result of carnitine deficiency?
A.) Adipate
B.) Citrate
C.) Orotate
D.) Kynurenate
A

A.) Adipate

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14
Q 
Which of the following is a urinary organic acid that becomes elevated as a result of Coenzyme Q10 deficiency?
A.) Vanilmandelate
B.) Succinate
C.) Pyroglutamate
D.) D-Lactate
A

B.) Succinate

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15
Q 
Which of the following is a urinary organic acid that becomes elevated as a direct result of biotin deficiency?
A.) Alpha Ketoglutarate
B.) Beta-hydroxyisovalerate
C.) Alpha keto-B-methylvalerate
D.) Alpha ketoisovalerate
A

B.) Beta-hydroxyisovalerate

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16
Q 
Elevation of which of the following urinary organic acids indicates that a patient has increased turnover of epinephrine?
A.) Homovanillate
B.) Vanilmandelate
C.) Kynurenate
D.) Hippurate
A

B.) Vanilmandelate

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17
Q 
Which of the following is a urinary organic acid that becomes elevated in a patient due to massive intestinal overgrowth of Lactobacillus acidophillus?
A.) D-Lactate
B.) D-Arabinitol
C.) L-Lactate
D.) D-Glucarate
A

A.) D-Lactate

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18
Q

Which of the following is the most common reason for finding elevated benzoic acid in urine?
A.) The liver is converting more toluene into benzoic acid.
B.) Hepatic coenzyme A levels are increasing.
C.) Pantothenic acid supplementation has been increased
D.) Hepatic glycine conjugation capacity has been exceeded.

A

D.) Hepatic glycine conjugation capacity has been exceeded.

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19
Q

Why would a high protein diet be ill-advised for the patient whose laboratory report indicates a pathological detoxifier pattern?
A.) It would exacerbate the effects of low Phase II detoxification capacity
B.) Phase I detoxification needs to be stimulated
C.) Methylation pathways would be overloaded
D.) Pathological detoxifiers have difficulty with ammonia clearance

A

A.) It would exacerbate the effects of low Phase II detoxification capacity

20
Q

What are urinary products of glutathione conjugation called? \n\n\nGamma-glutamyl conjugates \nGlycine conjugates \nSulfated esters \nMercaptans

A

Mercaptans

21
Q

Which of the following steps in gene expression can be altered by environmental factors?
A.) DNA transcription
B.) RNA translation
C.) Post-translational protein alterations
D.) All of the above are correct responses

A

D.) All of the above are correct responses

22
Q

If a patient is found to be homozygous for SNP that causes lowered activity of the enzyme required for conversion of dopamine to epinephrine, what laboratory report abnormality would show metabolic confirmation of the effect?
A.) Low urinary vanilmandelic acid
B.) High urinary vanilmandelic acid
C.) High urinary 5-hydroxyindoleacetic acid
D.) Low urinary pyroglutamic acid

A

A.) Low urinary vanilmandelic acid

23
Q 
Which of the following test results is a marker for chronic stress response?
A.) Low insulin
B.) High estradiol
C.) High thyroxin
D.) Low sIgA
A

D.) Low sIgA

24
Q 
Which abnormality is an indication of potential BH4 deficiency?
A.) Elevated plasma Phe/Tyr ratio
B.) Elevated serum PIVKA II levels
C.) Elevated urinary succinate
D.) Elevated urinary xanthurenate
A

A.) Elevated plasma Phe/Tyr ratio

25
Q

Which of the following is a function NOT served by the single carbon pool?
A.) Delivery of reducing equivalents to form BH4
B.) Delivery of formyl groups to form purines
C.) Delivery of methylene groups to form pyrimidines
D.) Delivery of methyl groups to form SAMe

A

A.) Delivery of reducing equivalents to form BH4

26
Q

Which of the following describes the ultimate event that results in greater intestinal calcium absorption due to the action of vitamin D?
A.) Enterocyte ribosomal synthesis of calbindin is increased B.) Magnesium is displaced from calcium transport channels C.) The amount of absorbable calcium in the gut lumen is increased
D.) The overall activity of enterocyte mitochondrial ATP production is stimulated

A

A.) Enterocyte ribosomal synthesis of calbindin is increased

27
Q 
Which abnormality is generally produced by having a fasting plasma specimen sit for 2 days in an outside pickup box during August?
A.) Elevated Gln/Glu ratio
B.) Elevated Gly/Ser ratio
C.) Very low phenylalanine
D.) Very low proline
A

A

28
Q 
In the absence of any other laboratory evidence, finding a pattern of strongly elevated serene with low glycine on a plasma amino acid profile would suggest deficiency of which essential nutrient?
A.) 5-Methyltetrahydrofolate
B.) Thiamin
C.) Vitamin C
D.) Vitamin D
A

A.) 5-Methyltetrahydrofolate

29
Q 
S-Adenoxylmethionine therapy is most likely to be helpful in cases where elevation of which amino acid is found?
A.) Phosphoethanolamine
B.) Hydroxylysine
C.) 3-Methylhistidine
D.) Taurine
A

A.) Phosphoethanolamine

30
Q 
A patient who shows a pattern of low levels for threonine, glycine and serine is a candidate for what type of specific amino acid supplementation
A.) Glutathione precursor
B.) Positively charged side chain
C.) Acid-yielding
D.) Branched-chain
A

A.) Glutathione precursor

31
Q 
Tyrosine is the precursor amino acid in the biosynthesis of which compound?
A.) Dopamine
B.) Serotonin
C.) GABA
D.) Melatonin
A

A.) Dopamine

32
Q 
Which specific compound, appearing at elevated levels in plasma or urine, would best identify a patient who habitually consumes chicken or turkey almost every day?
A.) Anserine
B.) Carnosine
C.) Xanthurenic acid
D.) Pipecolic acid
A

A.) Anserine

33
Q 
Elevated levels of which of the following fatty acids indicates general PUFA deficiency?
A.) Mead
B.) Alpha linolenic acid
C.) Stearic acid
D.) Oleic acid
A

A.) Mead

34
Q 
Which class of fatty acids can enter the beta-oxidation cycle without the involvement of the carnitine shuttle?
A.) Medium chain
B.) Long chain
C.) Very long chain
D.) Odd chain
A

A.) Medium chain

35
Q

Why is DHA extremely slow to rise when infants are fed formulas supplemented with flax oil?
A.) The peroxisomal degradation step required to yield DHA is very slow and inefficient
B.) The high tissue content of ALA slows the release of EPA by PLA2 enzymes
C.) Flax oil stimulates the removal of EPA from cell membranes for eicosanoid synthesis
D.) Flax oil stimulates the removal of DHA from cell membranes for eicosanoid synthesis

A

A.) The peroxisomal degradation step required to yield DHA is very slow and inefficient

36
Q 
Essential fatty acid deficiency results in rising levels of which fatty acid?
A.) Palmitoleic
B.) Arachidonic
C.) Linoleic
D.) Hexacosanoic
A

A.) Palmitoleic

37
Q 
A patient who shows steadily falling levels of erythrocyte arachidonic acid after initial normal levels were found would be suspected of excessive intake of which dietary oil?
A.) Fish
B.) Borage
C.) Coconut
D.) Corn
A

A.) Fish

38
Q

Among reports in the medical literature, which is the most commonly used specimen for arsenic exposure screening?A.) Urine
B.) Serum
C.) Whole blood
D.) Hair

A

A.) Urine

39
Q 
Which specific nutrient supplementation is most directly indicated for a patient with greatly elevated urinary quinolinate and very low plasma tryptophan?
A.) Niacin
B.) Manganese
C.) Thiamin
D.) Vitamin D
A

A.) Niacin

40
Q

Which laboratory result would provide biochemical confirmation of functional impact from a genetric polymorphism that impairs metabolism of catecholamines?A.) Low urinary VMA and HVA
B.) High urinary VMA and HVA
C.) High plasma Phe and low Tyr
D.) High urinary picolinic acid

A

A.) Low urinary VMA and HVA

41
Q 
When a patient's laboratory report shows very low zinc, what other abnormality takes on greatly added significance regarding need for clinical management?
A.) Elevated blood cadmium
B.) High erythrocyte magnesium
C.) Elevated urinary mercury
D.) Low stool predominant bacteria
A

A.) Elevated blood cadmium

42
Q 
If you had been monitoring a patient's urinary mercury levels monthly and notice a sudden increase, what kind of treatment procedure would be suspected as a major contributing factor?
A.) Dental amalgam removal
B.) Oral anti-fungal therapy
C.) Radiation for cancer
D.) Multiple weekly colonic therapy
A

A.) Dental amalgam removal

43
Q 
Considering the precursor amino acid for thyroid hormone production, which laboratory abnormality would suggest a potential line of specific nutritional therapy for a patient with negative autoimmune thyroid antibodies and chronically low thyroid function that is unresponsive to aggressive supplementation of iodine?
A.) Very high plasma Phe/Tyr ratio
B.) Very high urinary HVA/VMA ratio
C.) Very high erythrocyte Zn/Cu ratio
D.) Very high serum 2/16 estrogen ratio
A

A.) Very high plasma Phe/Tyr ratio

44
Q 
Which urinary organic acid profile elevated result would be suspected to have been produced by finding that the patient had consumed a large serving of bananas and black walnuts with her evening meal before the overnight urine specimen collection for the test?
A.) 5-Hydroxyindoleacetate
B.) 8-Hydroxy-2'-deoxyguanosine
C.) Xanthurenate
D.) Tricarballylate
A

A.) 5-Hydroxyindoleacetate

45
Q 
Which of the following compounds is NOT a tricarboxylic acid?
A.) Succinate
B.) cis-Aconitate
C.) Citrate
D.) Isocitrate
A

A.) Succinate

46
Q 
Dietary deficiency of which vitamin causes the situation known as the "Folate Trap?"
A.) Vitamin B12
B.) Vitamin B6
C.) Biotin
D.) Folate
A

A.) Vitamin B12

47
Q 
Which component of biological membranes is most highly susceptible to hydroxyl radical attack?
A.) Polyunsaturated fatty acids
B.) Saturated fatty acids
C.) Cholesterol
D.) Steroid hormones
A

A.) Polyunsaturated fatty acids

COMP EXAM 2022 (15 decks)

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